From metastatic disease to no evidence of disease after conversion liver surgery in advanced gastric cancer with liver metastases: A case report.
Dong Chen, Hanyu Wang, Lin Xu
✦ AI-curated · Sources linked
Case in brief
A 54-year-old woman with initially unresectable, HER2-negative, pMMR-by-IHC, EBER-positive gastric cancer and synchronous liver metastases received tislelizumab-based chemotherapy, with regimen changes after suspected platinum hypersensitivity. After 14 treatment cycles, endoscopic biopsy found no tumor cells and imaging showed marked regression of liver lesions. Following multidisciplinary review, selected liver lesions were resected and others ablated. The resected specimens contained no viable tumor, while the gastric primary was considered a clinical complete response on endoscopy and biopsy. Imaging showed no evidence of disease one month after surgery; longer-term outcome is unknown.
What made this case unusual
Pathological complete response was demonstrated only in the resected liver lesions; ablated lesions had no specimens for pathological assessment. The gastric primary was assessed clinically, not by resection, so the case does not establish a pathological complete response across all disease sites.
Diagnostic / clinical pearl
Distinguish pathological response in sampled, resected lesions from clinical response at unresected sites; ablation does not provide tissue for pathological confirmation.
Why it matters
The report documents short-term no-evidence-of-disease status after liver-directed conversion treatment, but the long-term benefit and the role of omitting gastrectomy remain uncertain.